Provider Demographics
NPI:1992066161
Name:BAYSINGER, KATHERINE (MD)
Entity type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:
Last Name:BAYSINGER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:208 COLLYER ST STE 301A
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02904-1560
Mailing Address - Country:US
Mailing Address - Phone:401-725-4888
Mailing Address - Fax:
Practice Address - Street 1:1430 HARPER STREET
Practice Address - Street 2:COLON & RECTAL SURGERY ASSOCIATES
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30901-3090
Practice Address - Country:US
Practice Address - Phone:706-724-5451
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-05
Last Update Date:2024-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA74470208600000X
RIMD18095208C00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
RIMD18095OtherSTATE MEDICAL LICENSE
GA1992066161Medicaid